Dr. Hall,
I am having problems with tooth #14, my upper 1st molar. This tooth has a filling in the center and the back left corner of the tooth is broken off and am having pain. I have consulted a dentist and he recommended a root canal treatment, post and crown to restore the tooth. What are pros and cons to simply having the tooth removed versus the root canal, post and crown procedure?
– Stephanie from Arkansas
Stephanie,
I would strongly recommend saving your upper left first molar, and here is why:
If this tooth is removed, the tooth behind it will slowly tip into the space, the one in front of it will drift backward a little, and the lower first molar will extrude. As a result, your bite on that side will be disrupted.
Having your bite disrupted this way always causes some degree of discomfort, and can sometimes cause a serious bite disorder, involving headaches and jaw pain.
When your teeth work and you can chew and they fit together in a comfortable rest position, it’s easy to take all of that for granted. But then, if you find that you don’t have a comfortable rest position where your teeth all fit together, it causes a constant strain on your jaw muscles leading to the problems I explained, and then you’ll begin to appreciate what you had.
You can lose a second molar (such as tooth #15) without much disruption of your bite. But a first molar, either upper or lower, is a key anchor tooth that helps keep all the other teeth in their correct positions. If avoiding pain and discomfort is important to you, I’d get the root canal and dental crown and save that tooth. And if it ever becomes impossible to restore that tooth, I’d have it replaced with a dental implant or a dental bridge right away, like within two to four weeks, before the other teeth have a chance to move into that space.
– Dr. Hall
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.